Healthcare Provider Details
I. General information
NPI: 1235522608
Provider Name (Legal Business Name): ALBEL ULTRASOUND IMAGING INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/10/2015
Last Update Date: 03/10/2015
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
428 ALLEN CT APT A
WHEELING IL
60090-6102
US
IV. Provider business mailing address
428 ALLEN CT APT A
WHEELING IL
60090-6102
US
V. Phone/Fax
- Phone: 773-946-0879
- Fax: 847-243-4903
- Phone: 773-946-0879
- Fax: 847-243-4903
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2471V0105X |
| Taxonomy | Vascular Sonography Radiologic Technologist |
| License Number | 122905 |
| License Number State | IL |
VIII. Authorized Official
Name:
ALEXANDRE
BELIANSKI
Title or Position: PRESIDENT
Credential: RVT
Phone: 773-746-0879